About 15 years ago, I was handed oversight on a contract to assess inter-departmental compatibility issues/solutions at a county hospital. It was the only community hospital (readily admitted the uninsured) in a metro that had just experienced a decade of double digit annual population growth. The system core consisted of two old mainframes and the admissions/billing/records were listed on the contract as being a COBOL package. I'd been chosen because in the early 80's I'd payed for a few semesters at a University by being a systems grunt on their mainframes, and used this as resume fluff. I picked the 2 best network guys who who were unencumbered domestically and went packing for a several month adventure...into a politicised madhouse run by morons.
The hospital was overseen by 6 politicians, 2 each from the 3 political entities the hospital's coverage encompassed, 1 ass kissing unelected local citizen of idle rich wife charitible time donating noteworthiness, and 2 silverback MDs. None of these individuals had any background in computer networks. Back then, many Medical offices had recently upgraded into Win3.11 for workgroups, and acquired accessibility to insurance information via a modem. A new digital dawning. The MDs were pretty cool, and were the only ones who actually tried to get a grasp of the problems and needs. The politicians were afraid of properly managing budgetary concerns, because they didn't want to be portrayed has fiscally irresponsible in their next election. The citizen board member was an asskissing, backstabbing cunt to the nth degree, whose wake in passage left a choking aroma of hairspray mixed with a scent of her perfume, which always reminded me of RAID®.
The IT staff was very competent considering their base pay was woefully substandard (good benefits though), and the budget a joke. The dual mainframe system was mirrored for redundancy, and in theory, one was for admissions/front office and the other for internal staff use. In reality there seemed to be a constant battle to keep the systems up, and very often all network calls were time sliced off of one mainframe while the other was being jerry rigged back into operations. Often that process included IT attempting to rewire burned boards, because the budget hadn't accounted properly for routine network replacements. That was the easy part though. When we started to check out individual departments, we discovered that all new equipment purchasing decisions was left entirely up to departmental heads, and the deciding factor had often been decided by which team of reps had thrown the best party, and far to often the choice had been a self-contained proprietary systems box without any default methods to call home to mother nix.
Neurology stands out in my mind, partially because I befriended and dated an EEG tech, and partly because the Departmental head was an expat UK pompous arse of a MD who'd practised in the US without green card for almost 20 years, and was in the process of receiving a free ride from INS (he had been paying taxes, somehow, but I never figured out how without a valid SSN). The EEG supervisor was an ignorant trailer trash woman from Houston, who spent a great deal of the workday teaching her daughter the ins and outs of scamming welfare cheese and milk for the gradbastardbaby, and who had managed to get credentialed without being able to begin to parse an EEG, or even having a fundamental understanding of just what the squiggly lines on the chart meant. She just said that it wasn't something EEG techs were supposed to do, that was a job for neurologists, and she was right, by the book, but tell that to a pediatric neurosurgeon resident who had called in an emergency late night EEG for an infant admitted with serious head trauma from a car accident, and desperately was in need of a bit of cluefullness, and unwilling to wait until 9 or 10 the next morning after the Department Head had arrived, settled in, and begun to read the inbox charts, because the infant's brain was swelling up against the skull.
The main EEG machine was a brand new box out of Boston, completely closed proprietarily. It burned data onto a disc referred to as a worm (write once, read many), and hospital costs ran a little over $60 each. Staff Neurologists wanted a digital method for their front offices to access EEG records. I contacted the manufacturer in an attempt to get file specs for the output to facilitate network compatibility, and was informed that it too was closed proprietarily, and refused to release it to me. Off the timesheet and together with the IT head, we backwards engineered the file format, and worked out a script to parse it into data he could handle on his mainframe. He then put together an exterior data tap, which did not break any warranty seals and was removable, that was able to feed into the main system. This was a bright spot in an ugly assignment.
The tech and I continued to communicate and occasionally date for a couple of years, until she finally got a clue, and accepted a group practise's offer to run their inhouse EEG lab, and got married a while after that. Needless to say, we no longer communicate on a regular basis anymore.